A few years ago, a Chicago-area fertility clinic ran a series of radio ads at the same early hour each morning. For weeks, I woke to a woman’s energetic voice cutting through the fog of my semiconsciousness, announcing her gratitude to the center’s reproductive specialists. “Without them,” she proclaimed brightly, “my baby wouldn’t have my blue eyes and my husband’s wide smile.”
Before stepping into Jasmin’s room, I slathered my hands with cold Purell and began the mundane ritual of donning my PPE. The smell of alcohol filled my nostrils as I grabbed a gown and the paper bag containing my N-95 mask and face shield. Like a seasoned soldier preparing for battle, I put on my gear with ease. With my gloves glued to my skin by sanitizer, I rapped on Jasmin’s door, asking permission to enter.
“Nothing in life is certain except death and taxes!” my dad often crows.
This phrase takes me back to my boyhood, watching the Cricket World Cup matches with him. Time and again, I would pray fervently for an Indian win, but watch in increasing desperation as India threw away an insurmountable lead and snatched defeat from the jaws of victory.
“How are you surviving the COVID-19 pandemic?”
Lately, this is my new opening question with patients who come for a routine office visit. As a cardiologist in a community-hospital setting, I see mostly elderly patients.
When I ask my patients this question as they sit on the exam table wearing their brightly colored masks, they usually answer, “I don’t go out much. When I do, I wear a mask and practice social distancing.”
In recent weeks, they’ve begun asking me questions–about the COVID-19 vaccine. Having just received the vaccine myself, I can describe the experience firsthand.
The year is 2015, and I’m on my thirteenth surgical mission, but my first to Venezuela. I am a plastic surgeon, traveling with a nonprofit that offers free plastic surgery for people with birth defects such as cleft lip. We’re making a two-week visit to the coastal city of Cumaná, 250 miles east of Caracas.
Halfway through our first day of surgery, I’m asked to come out to the waiting area to assess a young girl named Vanessa, whose mother has brought her as a walk-in patient.
In the time of COVID-19, healthcare workers are stepping up to care for massive numbers of patients. Often, they’re doing this without adequate resources. At the beginning of the pandemic, our hospital administration referred to this as “crisis standard of care”–which the US Institute of Medicine defines as “a substantial change in…the level of care it is possible to deliver, made necessary by a pervasive or catastrophic disaster.”
For many American doctors this model of care is new, but I would argue that for most health workers worldwide, it isn’t new at all.
The new patient’s name is Emmanuel. He was sent from his nursing home to our emergency room with a cough and fever. The oxygen level in his blood is well below normal, and he’s gasping for air.
It’s my third week in the local community hospital ER. I’ve been putting in extra on-call time during the COVID pandemic. It’s been rough to get back into the emergency setting while continuing my day job as a family doctor and medical educator. I’ve been sharing admissions with the hospitalist, who’s joined me in the on-call room.
“I’ll take him,” I tell my colleague.
The miracle was that this baby had lived at all. His mother called 911 while in labor, with heroin easing her pain and numbing her conscience. The paramedics arrived at the empty warehouse where she’d been living. She delivered her newborn son in a toilet. The paramedics scooped him out, cut his umbilical cord with her razor blade and brought mother and son to our hospital.
The fact that all this took place should be remarkable.
One morning seven years ago, I disappeared.
I started the day by swimming laps in the pool at the Northwestern University sports and recreation center in Evanston, IL, as I’ve done for at least fifteen years.
I have long suffered chronic muscle spasms and pain in my neck, hands and feet, and my daily swims, pain medications and mindfulness meditation make up part of a very helpful therapeutic regimen.
At around 9:00 am, having finished my laps, I felt some very mild tightness in my chest.
Thursday October 31, 2019, 11:00 pm: A forty-five-year-old woman named Maria drove her Subaru Forester along a Pennsylvania highway called the Blue Route, about fifteen miles west of Philadelphia. It was raining heavily. She drove more slowly than she ordinarily would, partly due to poor visibility but also because the wind seemed unusually strong. Her hands firmly gripped the vinyl steering wheel at 10:00 and 2:00, so as not to allow the vehicle to be blown about the road.
Maria was just about to switch the car radio to a news station, hoping to hear a weather report, when she saw the funnel cloud headed directly toward her.
A few months ago my friend Phil gave me a newspaper clipping from the Sunday New York Times on body-focused repetitive behaviors, from nail-biting to hair-pulling to skin picking. I know he gave it to me because he wanted to help me with my own problem. He’s heard me express my frustration about it at the support group for faculty in our family-medicine residency.
Drip.
Drip.
Drip.
It’s 8:00 pm.
I’m staring at the IV tubing. We forgot to stop the fluids.
I’m standing in the resuscitation room alongside the naked, broken body of a teenage male. Unable to break my gaze on that dripping IV line, thinking, We’re going to flood him.
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